Table 2.
Characteristics of reported patients with ICI-related T1DM and preexisting islet autoantibodies before ICI treatment
| Case 1 [Ref. 21] | Case 2 [Ref. 20] | Our case | |
|---|---|---|---|
| Age (years) | 73 | 34 | 55 |
| Sex | Male | Female | Male |
| BMI (kg/m2) | 28 | NA | 21.2 |
| Neoplasia | Melanoma | Non-small cell lung cancer | Renal cell carcinoma |
| History of diabetes before ICI treatment | No | No | Yes (SPT1DM) |
| ICIs | Nivolumab | Nivolumab | Nivolumab + ipilimumab |
| Clinical T1DM subtype | Acute onset type | Fulminant type | Acute onset type |
| Time and cycles to onset | 6 weeks and 3 cycles | 4 weeks and 2 cycles | 5 weeks and 1 cycle |
| Blood glucose (mg/dL) | 500 | 739 | 482* |
| Glycated hemoglobin (%) | 8.8 | 7.1 | 9.8* |
| Ketoacidosis | Yes | Yes | No* |
| CPR value before and after ICI treatment (ng/mL) | 1.19 → not detectable | NA → < 0.1 | 2.36 → 0.26 |
| Islet antibodies before ICI treatment |
GADA > 2000 IU/L IA-2A 15 U/mL ZnT8A 463 U/mL |
GAD-65A(RIA) > 250 U/L IA-2A 6.2 U/mL ZnT8A 64 U/mL IAA < 0.4 U/mL |
GADA 114 U/L |
| Islet antibodies at the presentation of ICI-related T1DM |
GADA > 2000 IU/L IA-2A 27 U/mL ZnT8A 802 U/mL |
GAD-65A(ELISA) > 30 U/L IA2A 6.1 U/mL IAA 0.4 U/mL |
GADA 1160 U/L IA-2A > 30 U/mL IAA < 125 nU/mL |
| HLA typing | NA | A*30:01/30:02, DR9 | DRB1*08:03/09:01 DQA1*01:03/03:01 DQB1*03:03/06:01 |
| Other autoimmune disease | No | No | Thyroiditis |
ICI immune checkpoint inhibitor, BMI body mass index, T1DM type 1 diabetes mellitus, SPT1DM slowly progressive type 1 diabetes mellitus, GADA anti-glutamic acid decarboxylase antibody, GAD-65A anti-glutamic acid decarboxylase-65 antibody, IA-2A anti-insulinoma-associated antigen 2 antibody, ZnT8A anti-zinc transporter 8 antibody, IAA insulin autoantibodies, HLA human leukocyte antigen, Ref reference number, NA not assessed
*Data after insulin treatment at the previous hospital